Caregivers' limited English skills can add to hospital stay

Children whose parents are less proficient are hospitalized longer than those whose caregivers are fluent.

By Carolyne Krupa — Posted May 31, 2011

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Children hospitalized with infections are likely to stay in the hospital longer if their parent or other primary caregiver speaks limited English, says a study published online May 2 in the Archives of Pediatrics and Adolescent Medicine.

Such patients also are 80% less likely to be referred for home health care services than patients whose caregivers speak proficient English.

The findings are significant, given that about one in five U.S. residents speaks a language other than English and about half of those have limited English proficiency, the study said (link).

"The most concerning consequences of such disparities always fall on the patients," said Michael N. Levas, MD, lead study author and third-year pediatric emergency medicine fellow at Children's Mercy Hospital in Kansas City, Mo. "Families that have a prolonged length of stay have to deal with more time off of work, child care issues for the children not admitted and cost of a prolonged hospital stay."

Researchers studied 1,257 patients requiring prolonged antibiotic treatment at Children's Mercy between 2001 and 2008. Of those, 3.1% had caregivers with limited English proficiency, while 96.9% had caregivers who spoke fluent English.

The median hospital stay was 4.1 days. Patients whose caregivers spoke limited English stayed in the hospital an average 2.5 days longer than those whose caregivers were proficient in the language, creating an increased cost of about $6,250.

Home health referrals were made for 32.6% of patients whose caregivers spoke proficient English, compared with 6.9% of patients whose caregivers had limited proficiency. Multiple studies have shown that patients who receive home health care use fewer resources and have better outcomes, the study said.

Dr. Levas said researchers were surprised by the breadth of the disparities. Children's Mercy, which offers interpreter services, is looking at ways to improve quality of care, regardless of language barriers, he said.

"In health care, we are always looking for ways to improve," Dr. Levas said. "Finding disparities allows us to look within ourselves and our system to make things more equal."

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